2019/20 SVC Coed House League Registration (Stratford Volleyball Club)

Print 2019/20 SVC Coed House League Registration
  1. SVC "House League" program is the recreational division of the Stratford Volleyball Club. This division is for boys and girls ages 8 to 14 years. 

    House League will begin on Sunday Nov 10, 2019 at 4:30 to 5:30pm at the Stratford Agriplex. House League ends Feb 9, 2019. (The program will not run on during the Christmas Break)

    Cost to play $150 which includes a t-shirt. Please complete the form below.

    Space is limited, so sign up early to avoid disappointment. Registration forms will be accepted on a first come, first serve basis and when the program is full registration will close.

    Preferred method of payment:
    INTERAC e-transfers
    Recipient Name: Ann McKay
    Email: [email protected]
    Under Message: Player's Name
    Security Question: Your Favourite Sport

    Alternate method of payment
    If an alternate method of payment is required please contact Ted Hopkinson at [email protected]

Participant's Information
Fill out information below for participant being registered.
  1. RadDatePicker
    Open the calendar popup.
    Example: Jan 01, 2016 or use Calendar selection
  2. Example: [email protected] Your submission will be sent to this address.

  3. Street, PO Box#, RR#, 911# etc
  4. Example: X1X 1X1
  5. Example: ###-###-####
  6. Select grade from drop down menu
Parent/Guardian Information
Fill out information for parent/guardian of participant being registered.
  1. Select from drop down menu
  2. Example: ###-###-####
  3. Example: ###-###-####
  4. If different then participants. Example: [email protected]
Emergency Contact Information
Fill out emergency contact information for participant being registered.
  1. Example: ###-###-####
  2. Example: ###-###-####
Medical Comments
Fill out any medical conditions for participant being registered
  1. ie: Allergies, Medical Conditions, Physical Limitations or Special Considerations
Additional Information
  1. Slide bar to appropriate choice on a scale of 1-5, 1 = Beginner, 5 = Advanced
  2. Size: Y = Youth, A = Adult (Please Check One)

    Please read the release in full

    I give my consent to SVC to photograph/video tape and then use, reproduce and publish said images of the above mentioned participant.I understand these images  may be used for a variety of purposes and may appear on the club website, in the local newspapers, on promotional materials or any other  media. I also understand that SVC will use the images exclusively for SVC related purposes and not for any commercial gain.  Since anyone can download an image from the Internet or make copies from printed  materials, I agree that SVC is not responsible for unauthorized use of  the images. I am aware that I am not entitled to any compensation for the use of the images.

    Please read the waiver/release in full

    I / We understand that the named participant (hereafter, the “Participant”) has made an application to be enrolled in an activity conducted at, sponsored by or involved in any way with Stratford Volleyball Club (hereafter referred to as “SVC”).  The undersigned participant and / or their parents or legal guardian acknowledge that:    
    i. I / We understand that there are risks of personal injury associated with the participation in volleyball training programs, events, and activities, which can result in temporary or permanent disabilities and severe personal loss and economic damages.  
    ii. I / We understand that SVC provides no pre-enrolment medical examination and takes no responsibility for monitoring and assessing the health and physical condition of the participant.    IN CONSIDERATION OF THE ACCEPTANCE OF THE PARTICIPANT’S APPLICATION / REGISTRATION TO ENROLL IN THE SVC PROGRAM, AND WITH THE KNOWLEDGE OF THE ASSOCIATED RISK TO THE PARTICIPANT, I / WE AGREE TO THE FOLLOWING.    
    iii. I / We consent to the participant enrolling in the SVC program, and participating in the events and activities which constitute the program.  
    iv. I / We will instruct the participant to review and carefully follow all of the SVC guidelines, rules and procedures of safety and general deportment while on the SVC premises, whether or not the participant is engaged in training events or activities at the time.  
    v. I / We accept and assume full responsibility for consulting with a doctor about the SVC programs and hereby warrant, represent, and state that the participant named below is in good physical condition and that the participant has no disability, impairment, or ailment that would prevent him/her from engaging in the SVC program or any of the events or activities or that would be detrimental to his/her health, safety, comfort or physical condition.  
    vi. In the event of an emergency, I / We grant permission for medical treatment to be given at a local hospital or by trained personnel onsite.  
    vii. I / We accept and assume all risk and responsibility for accidents, illness, injury, and/or damages which may result from the Participant traveling to or from or participating in any of the events or activities associated with the SVC program, and hereby waive, release and discharge SVC, its officers, directors, employees, and agents or anyone associated with SVC from any and all liability therefore   I / WE HAVE READ THE FOREGOING AND UNDERSTAND THAT ITS TERMS INCLUDE MY / OUR CONSENT AND MY / OUR AGREEMENT TO TAKE CERTAIN ACTIONS, TO ASSUME CERTAIN RESPONSIBILITIES AND TO RELEASE SVC FROM CERTAIN LIABILITIES.  I / WE SIGN IT VOLUNTARILY WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE.
Human Validation
Printed from stratfordvolleyballclub.com on Sunday, September 15, 2019 at 2:52 PM